ASCENSION PROVIDENCE HOSPITAL (NPI# 1528023587) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528023587 |
| Entity Type | Organization |
| Organization Name | ASCENSION PROVIDENCE HOSPITAL |
| Other Organization Name | PH PSYCHOLOGY PHD/PROVIDENCE HOSPITAL AND MEDICAL CENTERS INC |
| Practice Address |
16001 W 9 Mile Rd Southfield MI 48075-4818 |
| Mailing Address |
2800 Livernois Rd Suite 500 Troy MI 48083-1215 |
| Practice Telephone | 2488493000 |
| Practice Fax Number | 2488492244 |
| Mailing Telephone | 2486808000 |
| Mailing Fax Number | 2486808032 |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2018-12-04 |
| Authorized Official Name | SARAH STARKEL (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 2486808121 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | MI BLUE CROSS GROUP PIN # | 680F371930 | 01 |
| Other Name | Type Code |
|---|---|
| PH Psychology PhD/Providence Hospital and Medical Centers Inc | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225093776 | Ascension Providence Hospital | Nuclear Medicine | 2800 Livernois Rd, Blgd D Suite 500, Troy, MI 48083-1215 | 2006-04-19 |
| 1003892092 | Ascension Providence Hospital | Psychiatric Unit | 16001 W. 9 Mile Road, Southfield, MI 48075-4818 | 2005-12-21 |
| 1043385909 | Ascension Providence Hospital | General Acute Care Hospital | 47601 Grand River Ave, Novi, MI 48374-1233 | 2006-11-22 |
| 1851339196 | Ascension Providence Hospital | Nurse Anesthetist, Certified Registered | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2006-06-02 |
| 1003871062 | Ascension Providence Hospital | Pediatrics | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2006-04-20 |
| 1629033683 | Ascension Providence Hospital | Internal Medicine | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2006-04-20 |
| 1265497226 | Ascension Providence Hospital | Pediatrics | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2006-04-20 |
| 1619932670 | Ascension Providence Hospital | Psychiatry & Neurology | 16001 W 9 Mile Rd, Physician Billing Services, Southfield, MI 48075-4818 | 2006-04-20 |
| 1235194291 | Ascension Providence Hospital | Internal Medicine | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2006-04-20 |
| 1144285107 | Ascension Providence Hospital | General Practice | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2006-04-20 |
| Street Address |
16001 W 9 MILE RD |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48075-4818 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114929338 | Sally Rae Arbuckle | Registered Nurse | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2005-06-01 |
| 1730780651 | Jennifer Bekes | Nurse Anesthetist, Certified Registered | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2020-11-06 |
| 1497361133 | Matthew Hoffman | Nurse Anesthetist, Certified Registered | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2020-09-18 |
| 1447866215 | Marisa Mcalister | Nurse Practitioner | 16001 W 9 Mile Rd, Southfield, MI 48075-4803 | 2020-09-17 |
| 1629682935 | John Michael Faraj | Registered Nurse | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2020-09-03 |
| 1861017337 | Adnan Basheer | Internal Medicine | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2020-06-10 |
| 1891319885 | Seti Kelemework Belay | Radiology | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2020-06-04 |
| 1467076851 | Alexa Rae Arvidson | Internal Medicine | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2020-06-02 |
| 1275157638 | Angela Niezgoda | Obstetrics & Gynecology | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2020-06-02 |
| 1942824453 | Marc Thomas Zughaib | Internal Medicine | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2020-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851900054 | K&b Medical Wigs, LLC | Durable Medical Equipment & Medical Supplies | 16250 Northland Dr. Ste 221, Southfield, MI 48075 | 2020-07-24 |
| 1790300390 | Julian Jeberaeel | Radiology | 2250 Providence, Southfield, MI 48075 | 2020-06-10 |
| 1265056410 | Husein Yusuf Husein | Podiatrist | Ascension Providence Hospital Southfield Campus, 16001 W. Nine Mile Rd. Depaul 2nd Floor, Southfield, Mi, MI 48075 | 2020-06-03 |
| 1952945420 | Paris Straughter | Nurse Practitioner | 18438 Onyx St, Southfield, MI 48075 | 2019-10-29 |
| 1811467657 | Medicine Man Medical, Pllc | Physical Medicine & Rehabilitation | 25130 Southfield Road, Suite #210, Southfield, MI 48075 | 2018-12-04 |
| 1447725528 | Rommel Ramos Perez | Physical Therapist | 26017 Greenfield Rd., Southfield, MI 48075 | 2018-10-04 |
| 1073009627 | Jacqueline Venora Goodgame | Licensed Practical Nurse | 4000 Town Ctr, Southfield, MI 48075 | 2018-07-06 |
| 1043712532 | Hollie Marie Maltese | Physical Therapy Assistant | 22255 Greenfiled 118, Southfield, MI 48075 | 2018-03-01 |
| 1932601481 | Katie Marie Mccormack | Occupational Therapist | 16001 West Nine Mile Rd., Southfield, MI 48075 | 2018-03-01 |
| 1801304241 | Absolute Hc LLC | Physical Therapist | 23461 Greenfield Rd Ste 200b, Southfield, MI 48075 | 2018-01-19 |
| Find all providers in zip 48075 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093299711 | Little Charmers LLC | Psychologist | 24100 Southfield Rd Ste 110, Southfield, MI 48075-2850 | 2018-09-18 |
| 1871096248 | Evans & Associates Psychological and Counseling Services | Psychologist | 24100 Southfield Rd Ste 320a, Southfield, MI 48075-2819 | 2018-03-13 |
| 1699130195 | Robin Elaine Mccoy | Psychologist | 16000 W 9 Mile Rd Ste 200, Southfield, MI 48075-4808 | 2015-12-28 |
| 1700261989 | Kathryn Therese Combs | Psychologist | 29500 Southfield Rd Ste 100, Southfield, MI 48076 | 2015-07-29 |
| 1992196794 | Markie Silverman | Psychologist | 29228 Rock Creek Dr, Southfield, MI 48076-1831 | 2015-02-16 |
| 1114315645 | William Gurney | Psychologist | 22022 Indian St, Southfield, MI 48033-5022 | 2015-01-06 |
| 1033527338 | Dante Demitrius Dixson | Psychologist | 16250 Northland Dr Ste 204, Southfield, MI 48075-5226 | 2014-07-30 |
| 1497182828 | Atara Abramsky | Psychologist | 17240 W 10 Mile Rd, Southfield, MI 48075-2949 | 2013-09-30 |
| 1124365341 | Prestige Behavioral Therapy Development Center LLC | Psychologist | 28249 Bell Rd, Southfield, MI 48034 | 2013-01-08 |
| 1902142821 | Robyn Elana Glickman | Psychologist | 21395 Glenmorra St, Southfield, MI 48076-6016 | 2012-12-20 |
| Find all providers in SOUTHFIELD | ||||
| City | SOUTHFIELD |
| Zip Code | 48075 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.